SciELO - Scientific Electronic Library Online

 
vol.35 número9 índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


Actas Urológicas Españolas

versión impresa ISSN 0210-4806

Resumen

HUGUET, J.. Management of the male urethra before and after cystectomy: From the prophylactic urethrectomy to the intraoperative frozen section biopsy of the urethral margin. Actas Urol Esp [online]. 2011, vol.35, n.9, pp.552-558. ISSN 0210-4806.  http://dx.doi.org/10.4321/S0210-48062011000900008.

Context: Decision making regarding the urethra before and after radical cystectomy due to urothelial carcinoma has always been controversial. Objective: To analyze the changes produced in the management of the urethra from the beginning of the cystectomy up to the present moment. Evidence acquisition: Analysis of original articles and reviews obtained through a search in PubMed, related with the risk factors of urethral recurrence (UR) and with the management of the urethra in patients subjected to radical cystectomy. Evidence synthesis: At first, many authors recommended urethrectomy simultaneously with cystectomy. The identification of risk factors of the bladder tumor related with the appearance of UR limited the indication of prophylactic urethrectomy in patients with multifocal disease and with prostate tumor involvement. The development of orthotopic bladder substitutes (OBS) complicated the situation. The involvement the prostatic urethral tumor was maintained as the principal risk factor for UR, which then gave importance to its pre-cystectomy staging. Series of OBS observed a lower incidence of UR regarding patients with skin derivations, even in cases with prostatic urethral involvement. Prostatic urethral involvement stopped being a contraindication for OBS when the frozen section biopsy of the urethral margin was negative. Conclusions: Currently, most authors agree that the intraoperative frozen section biopsy of the urethral margin will determine whether an OBS or urethrectomy should be performed. In spite of this, we have very few series in which this approach has been systematically used and with sufficient follow-up.

Palabras clave : Cystectomy; Urethra; Recurrent; Urothelial carcinoma.

        · resumen en Español     · texto en Español     · Español ( pdf )

 

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons